Hehl G, Rapp F, Kramer M, Kinzl L, Krischak G
Abteilung Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum, Ulm.
Unfallchirurg. 1999 Aug;102(8):632-7. doi: 10.1007/s001130050459.
Between January 1986 and August 1995, we treated 86 patients suffering from lateral displacement of the patella with arthroscopic medial tightening and lateral release after a conservative functional treatment remained unsuccessful. 49 patients were available for follow-up studies. 29 patients were treated after primary dislocation of the patella, and 20 patients after recurrent dislocations (2-20). The lateral release was performed by arthroscopy in 28 patients and in 21 patients in an open procedure. The mean follow-up time was 47.3 months. The rate of reluxation was 8%. In the opinion of the patients, 44 (90% of the follow-up) operations were evaluated as good/very good, the average Lysholm score was 87.3 +/- 13.9. The clinical results were influenced by the point of time of the operation. Patients with monoluxation showed a lower rate of reluxation (3% vs. 15%) and superior functional and subjective results than those with recurrent dislocation. However, there were no significant differences between the open and closed performed lateral release. We recommend the technique presented here as a minimal-invasive method especially for patients with monoluxation of the patella.
1986年1月至1995年8月期间，我们对86例髌骨外侧移位患者进行了治疗，这些患者在保守功能治疗失败后接受了关节镜下内侧紧缩和外侧松解术。49例患者可供随访研究。29例患者在髌骨初次脱位后接受治疗，20例患者在复发性脱位后接受治疗（2 - 20次）。28例患者通过关节镜进行外侧松解，21例患者通过开放手术进行。平均随访时间为47.3个月。复发率为8%。在患者看来，44例（随访患者的90%）手术被评为良好/非常好，平均Lysholm评分为87.3±13.9。临床结果受手术时间点的影响。初次脱位患者的复发率较低（3%对15%），功能和主观结果优于复发性脱位患者。然而，开放和闭合式外侧松解之间没有显著差异。我们推荐这里介绍的技术作为一种微创方法，尤其适用于髌骨初次脱位的患者。
